In all the chaos of the year the good things that have occurred sometimes get lost among the patients who "no-show" their appointments, the endless prior authorizations, and lost prescriptions. As 2015 comes to a close and I prepare to tackle 2016 with its looming threats of increased quality benchmarks and value-based payment systems, I would like to take a moment to be grateful for the people and circumstances that got me through this year:
• A hardworking staff that has answered seemingly endless patient phone calls, scanned numerous documents, and carefully navigated my patients through the increasingly confusing matrix of the healthcare system.
• Patients who have waited in exam rooms past their appointment times while I tended to an emergent care issue or simply fell behind my schedule; those who called to cancel instead of merely skipping their appointments; and those who did not call for an urgent prescription for medications that they ran out of yesterday.
• Attentive nurses who have prepared me for the challenges on the other side of the exam room doors by taking the time to talk to our patients, while collecting vital signs and documenting chief complaints. They work hard behind the scenes to keep the schedule moving and provide an extra support for patients and families.
• Colleagues working hard to keep up productivity, yet have time to meet after hours on occasion to offer a little relief from the stress of the office; those willing to switch coverage and call when family emergencies rear up; and those willing to see an extra patient when I am falling behind schedule.
• Residents and medical students who force me to keep my knowledge up to date and challenge me to think about medicine and patient care in new, innovative ways. They constantly inspire me with their compassion and eagerness to care for patients in a time when physicians are dropping out of medical practice in the face of challenging times.
• The moments that renew my energy and remind me of why I chose this career: Guiding a pink, screaming baby into the world; congratulating a diabetic patient on managing to bring his condition under better control; telling a pregnant patient that the ovarian cancer found during a routine OB ultrasound was contained within the removed ovary, and she could continue her pregnancy.
There are immense challenges inherent in this profession. Every day I struggle to maintain autonomy while complying with government and payer regulations and keeping up productivity. Yet there are also incredible joys. Few get to have the opportunities I have had this year to hold the hands of those coming into this world, and those going out, all while caring for those in between. The surveys come out every year regarding the number of physicians opting out of practice or warning the younger generation to avoid the profession. Yet every year I continue to feel blessed to be physician. I would never say it is easy, but I have yet to find myself wanting any other career. I can only hope that as I move into the New Year, I can continue to find hope in the care I provide and opportunity to improve the system for patients as well as those providing their care.